Form LIC 508D. Out-Of-State Disclosure And Criminal Record Statement - California

Form LIC 508D is used in California by individuals who have lived out-of-state and are applying for employment or certification within certain regulated industries. The main purpose of this form is to disclose any criminal record history from their time living out-of-state.

The form consists of sections where the applicant provides personal information, including their name, address, date of birth, and social security number. Additionally, there are sections that require disclosure of any criminal convictions or pending charges that occurred while residing outside of California. The form may also include spaces for the signature of the applicant and the date of submission.

Important fields on this form include accurately disclosing any out-of-state criminal history, providing complete and truthful information, and complying with applicable regulations regarding disclosure and criminal record statements for individuals with out-of-state residency. It is essential for the applicant to be transparent about their criminal background to ensure compliance with licensing requirements and public safety.

Application Example: An individual who previously lived in another state is applying for a professional license in California. Form LIC 508D would be completed by the applicant to disclose their out-of-state criminal record. By submitting the form, the applicant demonstrates honesty and transparency, allowing the licensing authorities to assess their fitness for obtaining the license.

Related Forms: There are no specific related forms mentioned for Form LIC 508D. However, other documentation such as criminal record clearance forms, background check authorization forms, and reference letters may be required in conjunction with this form to ensure a comprehensive evaluation of the applicant's suitability for employment or certification within regulated industries.